CDN Anemia Management in Dialysis Patients

Question 1

According to KDIGO guidelines, what is the target hemoglobin range for dialysis patients receiving erythropoiesis-stimulating agent (ESA) therapy?

Accepted Answer

10–11.5 g/dL

Answer

KDIGO guidelines recommend maintaining hemoglobin between 10–11.5 g/dL in dialysis patients on ESA therapy to balance symptom relief while minimizing cardiovascular risks.

Question 2

What is the primary cause of anemia in patients with chronic kidney disease (CKD)?

Accepted Answer

Decreased erythropoietin production by damaged kidneys

Answer

The diseased kidneys produce insufficient erythropoietin (EPO), the hormone that stimulates bone marrow red blood cell production, making EPO deficiency the principal cause of CKD anemia.

Question 3

Which laboratory value best reflects total iron stores in dialysis patients when assessing for iron deficiency?

Accepted Answer

Serum ferritin

Answer

Serum ferritin is an acute-phase protein that reflects total body iron stores and is the most reliable single marker used to assess iron adequacy in dialysis patients.

Question 4

What transferrin saturation (TSAT) level is considered indicative of iron deficiency requiring supplementation in hemodialysis patients?

Accepted Answer

Less than 20%

Answer

A TSAT below 20% indicates insufficient circulating iron available for erythropoiesis and is a key threshold for initiating iron supplementation in hemodialysis patients.

Question 5

A hemodialysis patient has a hemoglobin of 8.4 g/dL, serum ferritin of 140 ng/mL, and TSAT of 17%. Which intervention is most appropriate?

Accepted Answer

Administer intravenous (IV) iron supplementation

Answer

With TSAT <20% and ferritin <200 ng/mL, this patient has iron deficiency anemia; IV iron is preferred over oral iron in hemodialysis patients due to superior absorption and avoidance of GI side effects.

CDN - Certified Dialysis Nurse Practice Test

CDN - Certified Dialysis Nurse Practice Test

CDN Anemia Management in Dialysis Patients